Thanks to Obamacare, virtually all Americans are now required to have health insurance. While some people may be getting free coverage through Medicaid or subsidized insurance on state and federal marketplaces, millions of families are shelling out more than $10,000 each year for their health care.
This year, the average family who gets health insurance through an employer will spend $10,473 on medical costs, which is 43 percent of the average total cost for family coverage through an employer-sponsored plan, according to the Milliman Medical Index. The remaining amount is typically paid by a business as a workplace benefit.
Employers may be picking up most of the cost, but families could still be feeling sticker shock about their portion of the bill. Fortunately, there are ways to reduce health care spending. Here are five suggestions to help you spend less on medical expenses this year.
Pick the right health insurance plan. Saving money starts by selecting the right health insurance plan. Chris Paddison, a health practice partner at consulting firm A.T. Kearney, says there are four pillars to choosing a plan that will keep costs down.
1. Coverage: What services will be paid for by the plan?
2. Cost: What are the premium, deductible and copay amounts?
3. Accessibility: Are in-network providers with convenient hours located nearby?
4. Quality: How is the health insurance company rated by organizations such as the National Committee for Quality Assurance?
“Health insurance is starting to become more like auto insurance and shifting to catastrophic coverage,” says Steve Auerbach, CEO of Alegeus Technologies, a company that helps manage consumer-directed health insurance. That shift toward catastrophic coverage means many people, whether they are selecting insurance through open enrollment at work or on a government health insurance exchange, will see the plans with the cheapest premiums have the highest deductibles.
“It’s great that you can get lower-cost premiums, but what are the caveats?” asks Abhinav Dave, executive vice president at insurance and business consulting firm VUE Software. The biggest drawback to these plans is that individuals may have to pay upward of $10,000 or more in deductible costs before the plan begins paying claims. Consumers with chronic conditions may find they save money by paying higher premiums for a plan with a lower deductible and more comprehensive coverage.
Keep all your services in-network. Another way to keep health care costs down is to keep services in-network. Most health insurance plans have an approved list of in-network providers and facilities. Using a facility or physician outside that network could result in substantially higher out-of-pocket costs or even a claim denial.
In some cases, a physician or surgeon may be part of an insurer’s network but a particular hospital or outpatient center is not. Before scheduling medical procedures, confirm that both the facility and health care professional are covered by your plan.
Compare prices for the best value. Just as with other products and services, there can be great variation in the price of health care. “In today’s world, we don’t buy a car or anything without shopping around, and we should do the same for health care,” Dave says.
A number of resources exist to help consumers compare prices. For example, Alegeus Technologies has a “Consumers Like Me” feature that helps members learn what people with a similar health status pay for their care, and many health insurance companies have pricing tools on their website. For those who have complex medical needs, a health care coach or advocate can help find lower prices.
“Employers and consumers are struggling. They’re confused,” Auerbach says. “The most successful tools are the ones that are simplifying data for consumers.”
Don’t be afraid to ask for alternate venues. Paddison encourages consumers to be aware health care providers may default to using specific hospitals or facilities, but that doesn’t mean there aren’t other options. “Recognize the bias of the health care delivery system in your area,” he says. “They’re going to try to keep you in their system.”
Even hospitals and facilities within the same system could charge different rates. Before scheduling a major procedure, ask where your physician or surgeon has the ability to practice. Then double-check prices, and don’t be afraid to go with the low-cost option. “There’s no relationship between cost and quality,” Paddison says of most health care markets. You aren’t necessarily going to get shoddy care by seeking out a less expensive hospital.
Follow your doctor’s orders. Americans have a poor track record when it comes to following through on doctors’ orders. Up to 30 percent of prescriptions are never filled, and half of medications for chronic conditions aren’t taken as prescribed, according to the Agency for Healthcare Research and Quality.
Failing to take medicine or engage in healthy behaviors, such as eating well or exercising regularly, can translate into bigger medical bills in the future. For instance, high blood pressure may be controlled with an inexpensive medication, but a person who stops taking the pills could experience a costly, not to mention life-threatening, stroke.
Historically, people have paid little attention to the cost of health care, but the public attitude appears to be shifting. “The last few years have seen consumers taking more ownership for educating themselves,” Dave says.
It’s not hard to be a savvy shopper for health care. It’s a matter of being aware of your health care needs and knowing there is likely more than one place and price for medical care.
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How to Be a Savvy Shopper for Your Health Care originally appeared on usnews.com
